[Repair of mutilations of the lacrimal apparatus].
Repair of mutilated lacrimal passages should be adapted to the anatomy and physiology. Whenever possible, this should be performed as an emergent operation and come in as part of an overall therapeutic strategy. Repair methods used are simple end-to-end approximation of permeable segments, in case of limited lesions, and use of arterial grafts or of adjacent, nasal or saccular mucous flaps, in case of extended lesions. When reconstruction is not feasible owing to the extent of the lesions or to failure of the repair methods, tear derivation is carried out directly via the lacrimal sac or nasal fossa, by means of intermediate flaps (primarily nasal mucosa) or indwelling drains. Objectively, the functional outcome of repair is hard to assess, as tearing can, by no means, be considered a clinical criterion of obstruction, in the same way as lack of tearing is not a criterion of permeability. Only dacryography or, when possible, postoperative scintigraphy of the lacrimal passages allow for an objective evaluation of the results. Thus, although satisfactory results are the rule, long-term objective observation often leads to mitigating feelings.
Gola
R
R
Service de Stomatologie et Chirurgie Maxillo-faciale, Hôpital Nord, Marseille.
Waller
P Y
PY
Chossegros
C
C
Semeria
E
E
Stricker
M
M
D003608:Dacryocystorhinostomy / Q000379:methods; D006801:Humans; D007765:Lacrimal Apparatus / Q000293:injuries* / Q000601:surgery; D008722:Methods
Réparation des mutilations des voies lacrymales.